EP0983022B1 - Vorrichtung und verfahren zur erzeugung eines anatomischen hohlraums für laparoskopische eingriffe - Google Patents

Vorrichtung und verfahren zur erzeugung eines anatomischen hohlraums für laparoskopische eingriffe Download PDF

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Publication number
EP0983022B1
EP0983022B1 EP98920272A EP98920272A EP0983022B1 EP 0983022 B1 EP0983022 B1 EP 0983022B1 EP 98920272 A EP98920272 A EP 98920272A EP 98920272 A EP98920272 A EP 98920272A EP 0983022 B1 EP0983022 B1 EP 0983022B1
Authority
EP
European Patent Office
Prior art keywords
balloon
distal
distal end
shaft
space
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP98920272A
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English (en)
French (fr)
Other versions
EP0983022A4 (de
EP0983022A1 (de
Inventor
Jan M. Echeverry
Luis M. Fernandez
James E. Jervis
Janine C. Robinson
Shigeru Tanaka
Laveille K. Voss
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Mallinckrodt Enterprises Holdings Inc
Original Assignee
General Surgical Innovations Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by General Surgical Innovations Inc filed Critical General Surgical Innovations Inc
Priority to EP10158209.6A priority Critical patent/EP2201898B1/de
Priority to EP10011586.4A priority patent/EP2266468B1/de
Publication of EP0983022A1 publication Critical patent/EP0983022A1/de
Publication of EP0983022A4 publication Critical patent/EP0983022A4/de
Application granted granted Critical
Publication of EP0983022B1 publication Critical patent/EP0983022B1/de
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/0218—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00535—Surgical instruments, devices or methods pneumatically or hydraulically operated
    • A61B2017/00557—Surgical instruments, devices or methods pneumatically or hydraulically operated inflatable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320044—Blunt dissectors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0813—Accessories designed for easy sterilising, i.e. re-usable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras

Definitions

  • the present invention relates to an apparatus according to the preamble of claim 1. Accordingly, the present invention relates generally to an apparatus for developing an anatomic space for laparoscopic procedures, and more particularly to an apparatus for providing laparoscopic visualization during tunneling to a desired anatomic space as well as during subsequent balloon inflation to develop the desired space.
  • a number of surgical devices may be used to develop a surgical space within a body.
  • blunt dissectors or soft-tipped dissectors may be utilized to create a dissected space which is parallel to the plane in which the dissectors are introduced into the body.
  • Such devices typically include an elongate shaft or obturator for tunneling into the body with the balloon attached to it.
  • the balloon is generally collapsed initially, for example by gathering the balloon about the shaft, and is secured to the shaft by a tubular sheath or cover.
  • the tunneling shaft with the deflated balloon thereon is introduced into the body and directed to a desired location. Once the desired location is reached, the balloon is deployed by inflation to develop the anatomic space, generally causing dissection along a natural plane within the tissue structures.
  • the lip on the tunneling shaft may result in a sharp distal edge.
  • This sharp edge may contribute to tissue trauma when the tunneling shaft is introduced into a body, and/or when the tunneling shaft is moved to observe the anatomic space being developed.
  • the sharp edge may also damage or puncture the balloon, possibly requiring removal and replacement of the device.
  • the present invention is generally directed to an apparatus for observing tissue dissection while tunneling to a desired location within a body and for developing an anatomic space at the desired location.
  • the apparatus includes a tunnelling member and an inflatable balloon.
  • the tunneling member comprises a substantially rigid tubular shaft having proximal and distal ends, having a passage extending between the ends, and having an opening in the proximal end to receive a conventional laparoscope.
  • the proximal end of the shaft may include a handle thereon for directing the shaft during a procedure.
  • the balloon is rolled, gathered or folded about the shaft of the tunneling member, or is provided pre-rolled, preferably as follows.
  • the bulge in the distal portion of the balloon is first rolled proximally onto the anterior or top surface of the balloon.
  • the sides of the balloon are then rolled laterally inward onto the posterior or bottom surface of the balloon, until the balloon is substantially collapsed around the shaft of the tunneling member.
  • the distal end of the tunneling member is directed to the outer edge of the distal portion of the balloon, the distal portion may not be rolled proximally before the sides are rolled laterally in.
  • the balloon is then secured, preferably by a removable sheath or integral cover that substantially holds the balloon until the balloon is ready to be deployed.
  • U.S. Patent No. 5, 540, 711 describes sheaths and covers that may be used for embodiments of a balloon in accordance with the present invention.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)
  • Surgical Instruments (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Claims (7)

  1. Eine laparoskopische Vorrichtung zum Erzeugen eines anatomischen Arbeitsraumes zwischen Gewebeschichten in einem Körper, wobei die Vorrichtung aufweist:
    ein Tunnelierungselement (20), das einen steifen Schaft (22) aufweist, der ein offenes proximales (24) und ein offenes distales (26) Ende aufweist und der einen Durchgang (28) aufweist, der sich zwischen dem proximalen und dem distalen Ende (24, 26) dadurch hindurch erstreckt, wobei der Durchgang angepasst ist, um darin ein Laparoskop aufzunehmen, wobei das distale Ende (26) eine Haltelippe (30) daran aufweist, die angepasst ist, um das Laparoskop davon abzuhalten, sich über das distale Ende (26) hinaus zu erstrecken, wobei sich die Lippe (30) von einem Teil des Umfangs des Schaftes (22) um das distale Ende herum radial nach innen erstreckt und teilweise eine Öffnung (32) benachbart zu der Achse des Schaftes (22) definiert, wobei die Öffnung (32) von einer Draufsicht auf den Schaft (22) aus gesehen einen schrägen Rand definiert, und
    einen Ballon (40), der einen aufblasbaren Raum aufweist und in der Lage ist, einen Zusammenlegzustand und einen Aufblaszustand anzunehmen, wobei der Ballon (40) eine proximale Hülse aufweist, um das distale Ende (26) des Tunnelierungselements (20) darin aufzunehmen,
    dadurch gekennzeichnet, dass das distale Ende (26) senkrecht zu der Achse des Tunnelierungselements (20) abgestumpft (Figur 2A) ist, um einen stumpfen distalen Rand (34) der Lippe (30) bereitzustellen, wodurch die Öffnung (32) um einen axial ausgesparten Zentralbereich (36) der Lippe (30) verlängert ist, die von dem distalen Rand (34) teilweise U-förmig umgeben ist, um das Verwenden eines geraden Laparoskops zuzulassen, um durch den Zentralbereich (36) hindurch axial aus dem distalen Ende (26) des Schaftes (22) herauszublicken.
  2. Die Vorrichtung gemäß Anspruch 1, wobei der Ballon (40) zwei Paneele aufweist, die entlang eines Saumes (56) im Wesentlichen miteinander verschmolzen sind, wodurch der aufblasbare Raum definiert wird, wobei der Saum (56) zumindest teilweise in den aufblasbaren Raum invertiert ist, wodurch der Saum (56) zumindest ein teilweise einspringendes Außenprofil aufweist.
  3. Die Vorrichtung gemäß Anspruch 1, wobei der Ballon (40) einen distalen Erweiterungsabschnitt (48) aufweist, wobei der distale Abschnitt angepasst ist, um proximal entlang einer Fläche des Ballons (40) gerollt zu werden, wodurch zumindest teilweise der Zusammenlegzustand definiert wird.
  4. Die Vorrichtung gemäß Anspruch 1, wobei der Ballon (40) ein Verstärkungspaneel (59) an einem Abschnitt des Ballons aufweist, wobei das Verstärkungspaneel ein transparentes flexibles Material aufweist, wobei das Verstärkungspaneel angepasst ist, um eine Durchstichwiderstands-Eigenschaft des Abschnitts zu verbessern.
  5. Die Vorrichtung gemäß Anspruch 4, wobei der Ballon (40) einen distalen Abschnitt (48) aufweist, wobei sich das Verstärkungspaneel (59) von einem äußeren Saum des distalen Abschnitts aus proximal erstreckt.
  6. Die Vorrichtung gemäß Anspruch 5, wobei sich das Verstärkungspaneel (59) entlang einer Innenfläche des distalen Abschnitts (48) proximal erstreckt.
  7. Die Vorrichtung gemäß Anspruch 4, wobei das Material des Verstärkungspaneels (59) aus demselben Material wie der Ballon (40) ist.
EP98920272A 1997-05-15 1998-05-05 Vorrichtung und verfahren zur erzeugung eines anatomischen hohlraums für laparoskopische eingriffe Expired - Lifetime EP0983022B1 (de)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP10158209.6A EP2201898B1 (de) 1997-05-15 1998-05-05 Aufblasbarer Ballon zur Erzeugung eines anatomischen Hohlraums zwischen Gewebeschichten
EP10011586.4A EP2266468B1 (de) 1997-05-15 1998-05-05 Aufblasbarer Ballon zur Erzeugung eines anatomischen Hohlraums zwischen Gewebeschichten

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US857193 1992-03-25
US08/857,193 US6015421A (en) 1997-05-15 1997-05-15 Apparatus and method for developing an anatomic space for laparoscopic procedures
PCT/US1998/009188 WO1998051222A1 (en) 1997-05-15 1998-05-05 Apparatus and method for developing an anatomic space for laparoscopic procedures

Related Child Applications (2)

Application Number Title Priority Date Filing Date
EP10158209.6 Division-Into 2010-03-29
EP10011586.4 Division-Into 2010-09-29

Publications (3)

Publication Number Publication Date
EP0983022A1 EP0983022A1 (de) 2000-03-08
EP0983022A4 EP0983022A4 (de) 2001-09-19
EP0983022B1 true EP0983022B1 (de) 2010-12-22

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Family Applications (3)

Application Number Title Priority Date Filing Date
EP10011586.4A Expired - Lifetime EP2266468B1 (de) 1997-05-15 1998-05-05 Aufblasbarer Ballon zur Erzeugung eines anatomischen Hohlraums zwischen Gewebeschichten
EP10158209.6A Expired - Lifetime EP2201898B1 (de) 1997-05-15 1998-05-05 Aufblasbarer Ballon zur Erzeugung eines anatomischen Hohlraums zwischen Gewebeschichten
EP98920272A Expired - Lifetime EP0983022B1 (de) 1997-05-15 1998-05-05 Vorrichtung und verfahren zur erzeugung eines anatomischen hohlraums für laparoskopische eingriffe

Family Applications Before (2)

Application Number Title Priority Date Filing Date
EP10011586.4A Expired - Lifetime EP2266468B1 (de) 1997-05-15 1998-05-05 Aufblasbarer Ballon zur Erzeugung eines anatomischen Hohlraums zwischen Gewebeschichten
EP10158209.6A Expired - Lifetime EP2201898B1 (de) 1997-05-15 1998-05-05 Aufblasbarer Ballon zur Erzeugung eines anatomischen Hohlraums zwischen Gewebeschichten

Country Status (8)

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US (2) US6015421A (de)
EP (3) EP2266468B1 (de)
JP (1) JP4592121B2 (de)
AT (1) ATE492216T1 (de)
CA (1) CA2289518C (de)
DE (1) DE69842063D1 (de)
ES (1) ES2355590T3 (de)
WO (1) WO1998051222A1 (de)

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Also Published As

Publication number Publication date
WO1998051222A1 (en) 1998-11-19
CA2289518A1 (en) 1998-11-19
US6168608B1 (en) 2001-01-02
DE69842063D1 (de) 2011-02-03
CA2289518C (en) 2006-07-04
EP0983022A4 (de) 2001-09-19
EP2201898B1 (de) 2013-04-24
EP2266468A1 (de) 2010-12-29
EP2266468B1 (de) 2013-04-24
US6015421A (en) 2000-01-18
EP2201898A1 (de) 2010-06-30
ES2355590T3 (es) 2011-03-29
EP0983022A1 (de) 2000-03-08
JP4592121B2 (ja) 2010-12-01
ATE492216T1 (de) 2011-01-15
JP2001527448A (ja) 2001-12-25
ES2355590T8 (es) 2011-05-18

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